H. D. Shin

Gender and ethnic differences in cancer pain experience: A multiethnic survey in the United States

Background: Inconsistent findings on ethnic differences in cancer pain experience suggest the need for further studies on this topic for adequate cancer pain management. Objectives: To determine ethnic differences in cancer pain experience of four ethnic groups in the United States. Methods: A feminist perspective was used as the theoretical basis. This was a survey of a multiethnic sample of 480 cancer patients asking questions on sociodemographic characteristics and health or illness status, 3 unidimensional cancer pain scales, 2 multidimensional cancer pain scales, the Memorial Symptom Assessment Scale, and the Functional Assessment of Cancer Therapy Scale. The data were analyzed using descriptive and inferential statistics including ANOVA and hierarchical multiple regression analyses. Results: The results indicated certain ethnic differences in types of pain and symptoms that patients experienced. Also, the results demonstrated significant ethnic differences in cancer pain and functional status. Discussion: The findings suggest further in-depth qualitative exploration on cultural values and beliefs related to cancer pain in each ethnic group and national studies with a larger number of ethnic minorities on this topic.

Anger, Anger Expression, and Suicidal Ideation in Korean Adolescents

This study described the levels of anger, anger expression, and suicidal ideation in Korean adolescents. Data from 18,752 adolescents were collected using a self-report questionnaire. Anger, anger expression, and suicidal ideation exhibited significant differences according to school level and gender. The group with higher anger and anger expression showed a higher average suicidal ideation score than that of the group with lower anger and anger expression, suggesting that school-based programs which alleviate anger may be needed to decrease suicidal ideation among Korean adolescents.

Suicidal ideation in adolescents: an explanatory model using LISREL.

Suicidal ideation has been reported to be a major factor in attempted and completed suicides. The purpose of this study is to test a structural model to explain adolescent suicidal ideation. Specifically tested is the relationship between the predictor variables of trait anger, anger suppression, entrapment, psychosomatic symptoms, depression, and resilience and the dependent variable of suicidal ideation. Data are collected from a convenience sample of 11,393 students from 36 middle schools and 23 high schools in Korea. Trait anger, entrapment, psychosomatic symptoms, depression, and resilience have a direct effect on suicidal ideation whereas anger suppression shows a significant indirect effect on adolescent suicidal ideation. The predictor variables account for 39% of the variance in suicidal ideation. The study findings suggest that future programs for prevention or alleviation of adolescents’ suicidal ideation need to use interventions that facilitate their resilience and reduce their anger, entrapment feeling, psychosomatic symptoms, and depression.

A Comparison of Two Pain Measures for Asian American Cancer Patients

Although two of the most commonly used multidimensional pain scales are the McGill Pain Questionnaire-Short Form (MPQ-SF) and the Brief Pain Inventory-Short Form (BPI-SF), there has been little psychometric analysis of these tools used among ethnic minority populations. The purpose of this study was to evaluate and compare psychometric properties of these two pain scales among 119 Asian American cancer patients. The Cronbachs alpha coefficients of the MPQ-SF and the BPI-SF were high (alpha = .85-.97). The correlation coefficients of the item analyses were .12 to .88 for the MPQ-SF and .44 to .90 for the BPI-SF. Two factors were extracted for both instruments. Correlations between pain scores and the usage of pain medications were low for the MPQ-SF (r = .23-.33) and moderate for the BPI-SF (r = .40-.42). The results of this study indicated that, among Asian Americans, both the pain scales were internally consistent; some items in each instrument were redundant; and the BPI-SF is more valid than the MPQ-SF.

Characteristics of cancer patients in internet cancer support groups.

The purpose of this study was to describe characteristics of cancer patients who were attending Internet cancer support groups and to provide direction for future research. A total of 204 cancer patients were recruited through Internet cancer support groups by posting the study announcement on the Web sites of such groups. The participants were asked to fill out Internet survey questionnaires on sociodemographic characteristics and health/disease status. The data were analyzed using descriptive and inferential statistics, including t tests, analysis of variance, and Chi-square tests. Findings indicate that cancer patients recruited through Internet cancer support groups tended to be middle-aged, well-educated, female, and middle class. The findings also indicate that there were significant differences in some characteristics according to gender and ethnicity. Based on the findings, some implications are suggested for future research using and developing Internet cancer support groups.

Bone Mineral Density, Biochemical Bone Turnover Markers and Factors associated with Bone Health in Young Korean Women

PURPOSE This study was done to assess the bone mineral density (BMD), biochemical bone turnover markers (BTMs), and factors associated with bone health in young Korean women. METHODS Participants were 1,298 women, ages 18-29, recruited in Korea. Measurements were BMD by calcaneus quantitative ultrasound, BTMs for Calcium, Phosphorus, Osteocalcin, and C-telopeptide cross-links (CTX), body composition by physical measurements, nutrients by food frequency questionnaire and psychosocial factors associated with bone health by self-report. RESULTS The mean BMD (Z-score) was -0.94. 8.7% women had lower BMD (Z-score≤-2) and 14.3% women had higher BMD (Z-score≥0) than women of same age. BTMs were not significantly different between high-BMD (Z-score≥0) and low-BMD (Z-score<0) women. However, Osteocalcin and CTX were higher in women preferring caffeine intake, sedentary lifestyle and alcoholic drinks. Body composition and Calcium intake were significantly higher in high-BMD. Low-BMD women reported significantly higher susceptibility and barriers to exercise in health beliefs, lower bone health self-efficacy and promoting behaviors. CONCLUSION Results of this study indicate that bone health of young Korean women is not good. Development of diverse strategies to intervene in factors such as exercise, nutrients, self-efficacy, health beliefs and behaviors, shown to be important, are needed to improve bone health.

First Report of Powdery Mildew Caused by Erysiphe cruciferarum on Indian Mustard (Brassica juncea) in Korea

Indian mustard (Brassica juncea (L.) Czern.) belongs in the Brassicaceae and is widely cultivated in Korea for the edible leaves. In May 2011, Indian mustard plants of cv. Cheong-Kyeoja, growing in polyethylene-film-covered greenhouses in Hwaseong, Korea, were observed to be affected by a powdery mildew. Symptoms appeared as circular to irregular white colonies, which subsequently showed abundant hyphal growth on both leaf surfaces. Severely infected plants were unmarketable due to leaf discoloration, and most were not harvested. Voucher specimens have been deposited in the Korea University Herbarium (KUS). Appressoria on the mycelium were well developed, lobed, solitary, or in opposite pairs. Conidiophores were cylindrical, 70 to 115 × 8 to 10 μm, and composed of 3 to 4 cells. Foot-cells of conidiophores were straight to substraight, cylindrical, and relatively short (20 to 30 μm long). Singly-produced conidia were oblong to cylindrical or oval, 27.5 to 50 × 14 to 17.5 μm with a length/width ratio of 1.8 to 3.6, with angular/rectangular wrinkling of outer walls, and lacked distinct fibrosin bodies. Germ tubes were produced in the perihilar position of conidia. No chasmothecia were found. These structures are typical of the powdery mildew Pseudoidium anamorph of the genus Erysiphe. The specific measurements and characteristics were consistent with previous records of Erysiphe cruciferarum Opiz ex L. Junell (1). To confirm the identification, the complete internal transcribed spacer (ITS) region of rDNA of KUS-F24819 was amplified with primers ITS5 and P3 (4), and sequenced directly. The resulting 462-bp sequence was deposited in GenBank (Accession No. KC862331). A GenBank BLAST search of the ITS sequence showed 100% identity (462/462 bp) with those of isolates of E. cruciferarum from B. oleracea var. acephala, B. rapa, and Arabidopsis thaliana (GU721075, EU140958, and FJ548627, respectively). Pathogenicity was confirmed through inoculation by gently dusting conidia onto leaves of five healthy, potted Indian mustard plants of the cv. Cheong-Kyeoja. Five non-inoculated plants served as a control treatment. Inoculated plants were isolated from non-inoculated plants in separate rooms in a greenhouse at 18 to 24°C. Inoculated plants developed symptoms after 7 days, whereas the control plants remained symptomless. The fungus present on the inoculated plants was identical morphologically to that originally observed on the diseased plants, fulfilling Kochs postulates. There are records of E. cruciferarum infecting B. juncea in Europe (Finland, Romania, Sweden, Switzerland), the former Soviet Union, Australia, South Africa, and Asia (India, Japan, and China) (2,3). To our knowledge, this is the first report of powdery mildew caused by E. cruciferarum on B. juncea in Korea. Occurrence of powdery mildew is a threat to quality and marketability of this crop, especially those grown in organic farming where chemical control options are limited. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No. 11. CBS, Utrecht, 2012. (2) D. F. Farr and A. Y. Rossman. Fungal Databases, Syst. Mycol. Microbiol. Lab., Online publication. USDA ARS. Retrieved 20 March 2013. (3) P. Kaur et al. Plant Dis. 92:650, 2008. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

First Report of Powdery Mildew Caused by Erysiphe macleayae on Macleaya microcarpa in Poland

Macleaya microcarpa (Maxim.) Fedde, also known as smallfruit plume poppy, is a perennial herb belonging to the family Papaveraceae. The plant, together with the better-known species M. cordata (Willd.) R. Br., is native to central China and is now planted worldwide for medicinal purposes. In October 2008 and August 2009, dozens of smallfruit plume poppy planted in the Kraków Botanical Garden, Poland, were found to be severely infected with a powdery mildew. White colonies with abundant sporulation developed on both sides of leaves and young stems, forming circular to irregular patches. Infections caused leaf yellowing and premature defoliation. The damage has been observed every year since 2009. Representative voucher specimens were deposited in the fungal herbarium of the W. Szafer Institute of Botany of the Polish Academy of Sciences (KRAM) and the Korea University herbarium (KUS). Appressoria on the mycelia were lobed, often in pairs. Conidiophores composed of three to four cells arose from the upper part of creeping hyphae, 65 to 120 × 7 to 10 μm, attenuated toward the base, sub-straight or slightly flexuous in foot-cells, and produced conidia singly. Conidia were hyaline, oblong-elliptical to doliiform, 25 to 38 × 12 to 18 μm with a length/width ratio of 1.8 to 2.6; lacked fibrosin bodies; and produced germ tubes on the subterminal position with club-shaped or lobed appressoria. The conidial surface was wrinkled to irregularly reticulate. No chasmothecia were found. The structures described above match well with the anamorph of Erysiphe macleayae R.Y. Zheng & G.Q. Chen (3). To confirm the identity of the causal fungus, the internal transcribed spacer (ITS) region of rDNA from KUS-F24459 was amplified using primers ITS5 and P3 (4) and directly sequenced. The resulting sequence of 553 bp was deposited in GenBank (Accession No. JQ681217). A GenBank BLAST search using the present data revealed >99% sequence similarity of the isolate with E. macleayae on M. cordata from Japan (AB016048). Pathogenicity was confirmed through inoculation by gently pressing diseased leaves onto leaves of three healthy potted plants. Three noninoculated plants served as controls. Plants were maintained in a greenhouse at 25°C. Inoculated plants developed signs and symptoms after 7 days, whereas the control plants remained healthy. The fungus present on the inoculated plants was morphologically identical to that originally observed on diseased plants. The powdery mildew infections of M. cordata associated with E. macleayae have been recorded in China and Japan (2), and more recently in Germany (1,3). To our knowledge, this is the first report of E. macleayae on M. microcarpa globally as well as in Poland. This mildew species was described in China and is endemic to Asia, where chasmothecia of the fungus were found. Only recently have powdery mildews been found on M. cordata in Germany (1,3) and now on M. microcarpa in Poland, indicating the fungus is spreading in Europe. References: (1) N. Ale-Agha et al. Schlechtendalia 17:39, 2008. (2) D. F. Farr and A. Y. Rossman. Fungal Databases, Systematic Mycology and Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , February 7, 2012. (3) A. Schmidt and M. Scholler. Mycotaxon 115:287, 2011. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

Health-Related Quality of Life During the Menopausal Transition: Testing a Theoretical Model

The purpose of this study was to test the hypothetical model of health-related quality of life (HRQOL) during the menopausal transition. The model was developed to test specific components of the Wilson and Cleary’s model for HRQOL. A cross-sectional, correlational study was carried out using self-report questionnaires on a convenience sample of 162 Korean women in the menopausal transition. The model was tested by a path analysis using Analysis of Moment Structure (AMOS) program. The path analysis showed that 5 affecting variables explained 69% of the variance in HRQOL during the menopausal transition. Based on the results, the Wilson and Cleary’s model may be useful in explaining HRQOL during the menopausal transition. Symptoms, functional status, and health perceptions mediated the effect of individual and environmental characteristics on HRQOL. However, the results suggest that some paths need to be added or modified in the model. To date, most research using Wilson and Cleary’s model has been conducted in the United States, Africa, and Europe (e.g., Austria, Norway, and Spain). This study shows the applicability of the model in Asian people.

Anger, anger expression, cardiovascular risk factors, and gastrointestinal symptoms by hwa-byung symptoms in Korean adult women

PURPOSE This study explored relationships of anger and anger expression to cardiovascular (CV) risk factors and gastrointestinal (GI) symptoms in Korean women based on hwa-byung (HB) symptoms. METHODS A descriptive, comparative design was used. One-hundred four women who are from 20 to 65years old were recruited. Based on the HB score, 22 women indicated for HB and the rest were classified as normal. Data collection was done with several questionnaires including HB symptom scale, state-trait anger expression inventory, and GI symptom questionnaire and clinical information. RESULTS Women with HB demonstrated significantly higher levels of trait anger and dysfunctional anger expression such as anger suppression and anger expression than normal group. Although blood pressure was higher in women with HB, the differences were not significant. Self-report of GI symptoms were significantly more in women with HB, however no significant difference was found in gastroscopy results. CONCLUSIONS Women with HB were younger and might lack of sufficient social support. This study suggests relationship of anger and anger expression to functional GI symptoms. Characteristics of women with HB should be considered in developing intervention programs for healthy coping. Future studies need more women with HB for better comparison.